SHELLIE A GREEN (NPI# 1124636113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124636113 |
| Entity Type | Individual |
| Full Name | SHELLIE A GREEN |
| Other Name | SHELLIE A COUNTRYMAN |
| Practice Address |
160 Stone St Watertown NY 13601-3250 |
| Mailing Address |
2697 Main St Buffalo NY 14214-1701 |
| Practice Telephone | 5853718373 |
| Practice Fax Number | 3152227435 |
| Mailing Telephone | 5853718373 |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F346037-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740718337 | Shellie Green | Specialist | 186 Powderhorn Dr, Taunton, MA 02780-1233 | 2017-05-26 |
| Street Address |
160 STONE ST |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-3250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407907215 | Planned Parenthood of The North Country New York, Inc. | Case Management | 160 Stone St, Watertown, NY 13601-3250 | 2007-01-16 |
| 1811509276 | Lisa Dwello | Physician Assistant | 160 Stone St, Watertown, NY 13601-3261 | 2020-08-18 |
| 1477163426 | Samantha Jo Furman | Family Medicine | 160 Stone St, Watertown, NY 13601-3250 | 2020-08-05 |
| 1912491374 | Jordan Robert Woodside | Nurse Practitioner | 160 Stone St, Watertown, NY 13601-3250 | 2018-06-19 |
| 1417470857 | Jordan Garry | Nurse Practitioner | 160 Stone St, Watertown, NY 13601 | 2017-07-18 |
| 1740632033 | Stephanie Boswell-davies | Midwife | 160 Stone St, Watertown, NY 13601-3250 | 2016-07-11 |
| 1992157291 | Gina Brandolino | Nurse Practitioner | 160 Stone St, Watertown, NY 13601-3250 | 2016-07-11 |
| 1326426487 | Abbey Jane Darling | Physician Assistant | 160 Stone St, Watertown, NY 13601-3261 | 2015-05-09 |
| 1477961217 | Shae Johnston | Nurse Practitioner | 160 Stone St, Watertown, NY 13601-3250 | 2014-07-24 |
| 1841631686 | Evelyn Nichole King | Nurse Practitioner | 160 Stone St, Watertown, NY 13601-3250 | 2013-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043810013 | Alexa L Carolan | Nurse Practitioner | 24 Penny Ln, Watertown, CT 06795-1734 | 2020-10-29 |
| 1104433820 | Jennifer Blaze Laclair | Nurse Practitioner | 26561 State Route 3, Watertown, NY 13601-1749 | 2020-09-27 |
| 1144839549 | Kristin Nicole Hill | Nurse Practitioner | 2813 Bell Rd, Watertown, TN 37184-4716 | 2020-07-31 |
| 1811505738 | Ashley Swan | Nurse Practitioner | 1571 Washington St Ste 107, Watertown, NY 13601-9304 | 2020-07-16 |
| 1518591619 | Kelly A Blanchette | Nurse Practitioner | 204 Arsenal St Apt 489, Watertown, MA 02472-3092 | 2020-02-27 |
| 1215586854 | Ashley Rydquist | Nurse Practitioner | 926 N 4th St, Watertown, WI 53098-2915 | 2019-09-06 |
| 1184133738 | Melissa Mcintyre | Nurse Practitioner | 70 Fieldwood Rd, Watertown, CT 06795-3023 | 2017-09-27 |
| 1346783669 | Nagma Kc | Nurse Practitioner | 263 School St, Watertown, MA 02472-1412 | 2016-11-18 |
| 1477007730 | Neangkanika Chea | Nurse Practitioner | 2 Repton Place, Apt 2204, Watertown, MA 02472 | 2016-08-04 |
| 1598122947 | Charles Staples Jr. | Nurse Practitioner | 205 Sylvan Lake Rd, Watertown, CT 06779-1450 | 2016-01-15 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.